ICD-10 Code K35.32 – Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code K35.32 – Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess
What it is
This code identifies acute appendicitis that has progressed to perforation, gangrene, and localized peritonitis, but no abscess is documented. Use it when the record clearly states these complications together.
Clinical signs
Typical findings include right lower quadrant abdominal pain, rebound tenderness, guarding, and signs of localized peritoneal irritation. Clinical features vary; refer to documentation for confirmation of perforation, gangrene, and absence of abscess.
When to use this code
Use K35.32 when the provider documents acute appendicitis with perforation and gangrene, plus localized peritonitis, and specifically notes no abscess. It may also apply when operative or imaging reports support these findings. If the record is unclear, check documentation before coding.
Do not use for
Do not use this code if an appendiceal abscess is documented, or if perforation, gangrene, or localized peritonitis is not confirmed. Do not assume these complications from pain alone.
Coding tip
Code the highest documented severity only when the record explicitly supports each element and the absence of abscess.